The Ableist Immigration Policy You Didn’t Know About

Words by Niamh Vaughan (she/her)

My brother has undiagnosed autism. Our parents recognised his autism when he was about 9-years-old, but without the support from any of the three schools he attended, he was unable to be officially diagnosed. Now we are in our 20s and a diagnosis still seems unavailable to him. 

Not long ago, I was at my brother’s house while he was scrolling through r/autism. I was complaining about how messy his room was and, almost as if it was summoned by my words, a meme on his computer screen popped up calling out neurotypical people for not being understanding of autistic executive function. I asked him if he’d ever get diagnosed to receive more support. I was surprised to hear he had decided pretty firmly against it. Other than the impossibly long waitlist, a diagnosis comes with other limitations, he told me. Apparently lots of countries have laws against autistic people immigrating and he doesn’t want to have his dream of a life overseas cut off. 

I couldn’t believe it. 

What countries could be so openly discriminatory and how could they possibly justify such exclusion? My brother started listing places he wouldn’t be able to live with a diagnosis: Singapore, the UK, and even Australia. “Lucky I was born in New Zealand,” he said finally, “because if I didn’t, I wouldn’t be allowed to move here either.”

“I've refused to get a formal diagnosis because I grew up in Australia and plan on moving back there eventually,” Teddi, a fellow Salient writer, told me. “Because I don't have a formal diagnosis, [I feel like I can’t] be out and proud about [having autism] because I can get discriminated against [and] I'm not legally protected. The fact that I want to get citizenship in Australia means that I lose the protections I get from being diagnosed.” Teddi explained that though Immigration New Zealand (INZ) does base their decision off whether an individual has ‘severe’ autism, the measure and use of functionality labels within autism is still problematic. “[Whether someone is high or low functioning is based on] how they interact with neurotypical people. It's nothing to do with how you are able to function within your daily life. It's basically [just] how well can you [mask or] pretend to be like everyone else.”

According to the INZ Operational Manual, my brother and Teddi fall into one of the many groups that do not meet the ‘Acceptable Standard of Health’ required to receive New Zealand residency.  And it's not just autistic people being discriminated against by NZ policy. Some of the “medical conditions deemed to impose significant costs and/or demands on New Zealand's health and/or education services'' include physical disabilities, intellectual disabilities, brain injuries, psychiatric illness, and addiction or past hospitalisation, along with an extensive list of medical conditions. Those with Alzheimer's, Parkinson's, or those who are paraplegic may be denied residency, often at the cost of separation from their families.

Though it seems like very few Kiwis born with residency know about the Acceptable Standard of Health policy, our news is flooded with horror stories of rejections every year. Registered nurse Jeena Rose had a daughter denied residency due to Marfan syndrome, despite four individual doctors’ notes deeming the young girl’s condition to be no risk to the health care system. Last year, Eder Rivera was denied for being, quote, “too fat”. INZ determined his BMI (body mass index) to be a “severe risk”, despite Rivera’s doctors saying he was in good health.  Petro Viljoen was denied residency for similar reasons, all while her husband was dying of cancer and she had to leave him in New Zealand. Gail Alfonzo and her partner were granted residency whilst their autistic daughter was denied, and Professor Dimitri Leemans and his family was forced to leave after immigrating to New Zealand because of his autistic step-son. 

Juliana Carvalho had a very public battle against the Acceptable Standard of Health policy, and can tell one of the very few stories with a happy ending. Carvalho first applied for residency in 2014. As a wheelchair user and person with lupus, she was unhappy with INZs health policy, but she still remained confident about her application. She felt like she deserved a medical waiver because of what she could bring to New Zealand after an illustrious career in Brazil. “The process is so bureaucratic, stressful, humiliating, dehumanising,” Juliana told me. “You need to prove your value, prove that you deserve to exist and to be here.” For a medical waiver, an applicant’s potential worth to the country is measured up against their potential cost. Juliana’s lupus had been stable for ten years and she was in remission. She was working full-time and paying taxes. She had strong evidence of a high-profile career back in Brazil. Almost her entire family was living in New Zealand with her. Yet her application was rejected. 

Ironically, the threat of potential deportation caused enough stress for Juliana to end up having a lupus flare. Even still, the first thing she did after being released from hospital was go straight to the Ministry of Justice. The Immigration and Protection Tribunal decided INZ had done an unfair and incorrect assessment of Juliana’s medical waiver. The judge even told Juliana that it could have only been someone who didn’t pay any attention to the wealth of her contribution that could’ve made such a decision. So began the second wave of her medical waiver. “But after another 19 months of trying to prove my value,” Juliana told me, “they said no for the second time. I couldn’t even read the medical reports. It was so awful. So awful to be reduced to a price tag [...]. I was working full time, paying taxes like everybody else [...]. It was like I was broken. I got really, really depressed, doubting my value as a human being.” Juliana started to feel like the burden that New Zealand was so determined to tell her she was. 

This stress and depression caused more health issues that sent Juliana to hospital eight different times in a year. “Christmas, New Years, my birthday, all in hospital—it was the year from hell.” When Juliana applied for yet another work visa, again it was a ‘no’ on grounds of her recent hospital visits. All her years of contribution to the country were ignored in favour of 12 months that Juliana didn’t feel reflected her actuality. “My reality was denied,” she said. 

But it was still against her core favours to give up. “I came to the realisation that this was not just about me. This was bigger than immigration–it was about [fighting against] the whole narrative that if you have a disability or a chronic health condition you are less of a human.” Juliana decided to fight till the end for change.

She started with a petition to end discrimination to honour the UN Convention on the Rights of Persons With Disabilities—focusing on Article 18 which is concerned with liberty of movement and nationality. Next was an open letter to the New Zealand Immigration Minister, and a video detailing all the things she could do as a wheelchair user—drive, ride a horse, dive with sharks—but still not attain NZ residency. All at the same time, Juliana had 42 days to appeal against her impending deportation. Again, another ‘no’. INZ deemed her more able to restart life in Brazil, and only gave her three months to get her affairs in order, say her goodbyes, and leave the country. 

The last option for Juliana was ministerial intervention. She wrote to the Minister of Immigration, but in the same week that her appeal was lodged, the first Covid-19 lockdown hit. She was able to work again because of another three-month working visa, granted and extended thanks to New Zealand’s desperation for migrant workers. Then one day at work, Juliana got a call from her lawyer. The minister had made a decision. After years of a seemingly endless battle, she had finally received her well deserved residency. 

It wasn’t long until Juliana banded together with others affected by INZ’s harsh policy and formed Migrants Against Acceptable Standard of Health Aotearoa (MAASHA), an all-volunteer group created to support and advocate for others affected by the unjust health policy. Umi Asaka, originally from Japan and also involved with MAASHA, told me about her experience of receiving residency in New Zealand. “I received mine through the Resident Visa 2021 (RV21) pathway, but if it wasn't for that pathway, I don't know if I've ever gotten it.” Umi is also a wheelchair user due to her osteogenesis imperfecta, a condition that gives her more fragile bones than other people. Though Umi says her condition was not specifically on the list that “discriminates and rejects people”, when she was on her initial student visa, she was still forced to get a medical assessment every year instead of the standard one every three years. “It was a strain [both] mentally and financially,” she said.

The RV21 pathway was created during the midst of the pandemic, during a migrant and worker shortage. The only people in need of a medical waiver were those in full-time care or supported with dialysis. People like Umi were able to receive their residencies without the mental and physical battle the Juliana had to face—the battle that Umi was expecting. “I joined MAASHA before I actually found the RV21 pathway, so I know how much of a challenge it could have been.”

MAASHA’s vision is to abolish the Acceptable Standard of Health policy and create a community for individuals and families impacted. The focus is on both individual and systemic advocacy by providing support for people as well as working to deconstruct the policy itself. “It’s like they use a crystal ball, because how on earth can you predict what will happen with someone’s condition, or how much someone will contribute to the country, [...] especially [with the] kids [affected],” said Juliana. 

“It all comes down to how we value disabled people,” Umi continued. “The irony of this policy is that if you’re a migrant [who] got latency then had an accident and became disabled after, there are no implications for that. But if you are disabled from the beginning, then you are automatically rejected from settling in the country. [...] Anyone can become disabled at any time in their life, and it doesn’t make their life more or less valued than before.”

This policy reduces disabled people to a perceived economic burden. 

For Juliana and Umi, their advocacy isn’t about disproving their ‘perceived cost’, because to them, that’s easy. Their work is about fighting for justice so that, in future, people like them won’t have to exert copious amounts of energy to validate their existence and prove their worth to this country. The RV21 pathway is a first step from the government of recognising the value of our immigrants. At the time of its creation, the healthcare system was under the most strain in recent history, yet this wasn’t in consideration when the country was desperate for workers. When push came to shove, the country noticed just how valuable immigrants are and that their value was far superior to any predicted cost. 

So where is the policy change?

We can adopt the mindset that disabled people are too expensive if we want. We can play the game of prediction and forecast the worst possible scenario. We can demand the Acceptable Standard of Health’ but such an action lacks the logic and reason that it boasts. Even if there’s a could-be resident with one of the conditions on the policy’s list, there’s no stopping an able-bodied resident from developing the same one tomorrow. 

There’s no way to determine how much healthcare a person will need to access. And if the Acceptable Standard of Health exists to prevent strain on our public health system, then why does INZ refuse to take into account whether an individual has access to private healthcare? 

C’mon NZ government, tell us what the real motivations are here if they aren’t ones solely based in excluding disabled and chronically ill people. 

At best, this INZ policy is outdated, archaic, and discriminatory. At worst, it's deeply ableist and upholds pro-eugenics values. This policy dictates the fate of thousands of people a year, and a change is not only morally imperative but well overdue. 

This injustice is everybody’s problem. 

This isn’t just a neurodivergent  or disability issue. 

It’s a human rights one!